“The palliative community has common ground with much of what she has expressed. It is only the last chapter of her story that deviates from theirs. ”

Jack P. Freer, MD, Clinical professor

UB Department of Medicine

BUFFALO, N.Y. – The assisted-suicide death of Brittany
Maynard, the 29-year-old California woman with advanced brain
cancer “is a tragic and poignant case that moves people who
thought they had assisted suicide settled and all worked out in
their minds,” says Jack P. Freer, MD, clinical professor in
the University at Buffalo’s Department of Medicine.

Freer is a primary care physician who cares for chronically ill
and elderly patients with UBMD, the practice plan of the University
at Buffalo School of Medicine and Biomedical Sciences. An expert in
the fields of geriatrics, palliative care and biomedical ethics, he
is responsible for research ethics at UB’s Clinical and
Translational Research Center, where he founded and chairs the
monthly Clinical and Research Ethics Seminar.

He notes that this case, in particular, has captured the public
imagination for several reasons.

“Brittany's youth and vitality, as well as her articulate
and rational justifications, all seem to distinguish this from
previous stories of medically assisted dying,” he says.

“This is a story that prompts partisans from various
points of view to apply their worldview to Brittany's situation.
Certainly, those who advocate a right to die found an enthusiastic
and powerful spokesperson. Judging from the comments on the YouTube
and People Magazine websites, there was also a strong pro-life
contingent that urged her to abandon her plans and pray for a
miracle.”

In particular, Freer notes, members of the hospice and
palliative care community have been especially affected by this
case.

“These are people who have worked hard over the past few
decades to change the way people die in this society,” he
says. “They have transformed the way we approach death,
providing humane, medically competent care to dying patients in
their homes, surrounded by family and loved ones.

“This last group is the most conflicted. The first two
simply see Brittany’s situation through the lens of their
particular ideologies. But, the palliative community has common
ground with much of what she has expressed. It is only the
last chapter of her story that deviates
from theirs.”

He adds that in 1994, when the Oregon Death with Dignity Act was
being debated, the Oregon Hospice Association opposed it.
“Now, the organization works more closely with groups like
Compassion & Choices, which supported Brittany Maynard’s
decision,” Freer points out.

“Palliative people understand what motivates someone to
take the path that Brittany Maynard did. They also know this issue
is a hot button that could undercut public support for the kind of
care they have worked so hard to provide.​

“Ultimately, it is probably the subtle differences in
perspective, personality and desire for control that will lead some
to a more traditional hospice/palliative path to avoid the
suffering of a medicalized death,” concludes Freer,
“while others feel the need to deliberately and directly
dictate how that story ends.”